Abstract No. : ABS3567: The feasibility and impact of acute normovolaemic haemodilution in on-pump cardiac surgery: a descriptive study

BACKGROUND & AIMS: Cardiac surgeries have the potential of perioperative blood loss, allogenic blood transfusion, prolonged postoperative hospitalstay and thus increase the load on the blood bank in the hospital. We evaluated the feasibility and impact of acute normovolaemic haemodilution (ANVH) in on-pump cardiac surgery. METHODS: The data of 195 patients undergoing on-pump cardiac surgeries (coronary artery bypass graft surgeries, single/double valve repair surgeries) was retrospectively retrieved. Pre-operative haemoglobin >12 gm % was taken as criteria for ANVH. The amount of blood withdrawn was replaced withcrystalloid in a 1.5:1 ratio. The noradrenaline 4 µg/ml bolus was used to maintain the haemodynamics if required. The bloodwas re-transfused after protamine administration. The threshold for autologous blood transfusion was taken as <8 gm/dl. RESULTS: In 75.38% (147) patients, ANVH was carried out. The mean pre-operative haemoglobin of patients who underwent ANVH was 13.5 gm%. An average of 1.44 units of blood was withdrawn. Allogenic blood transfusion was required in 23.40% of patients.Six patients were re-explored for surgical cause and excluded from the analysis. Mean 0.5 units of packed red blood cells (PRBC) were transfused in the post-operative period. The haemodynamics were maintained during ANVH. CONCLUSION: ANVH is feasible in the majority of patients, drastically reduces the requirement of allogenic blood transfusion in patients undergoing on-pump cardiac surgeries without much problem in maintaining haemodynamics.